Time to put away the keys?: Some older drivers will need help to stay on the road

Occupational therapists Eileen Kennedy (seated) and Katie Hoiland demonstrate a computerized driving simulator, part of the comprehensive testing available at Enloe Rehabilitation Center. A driving evaluation appointment can be made by calling Enloe at 332-3254. (Submitted Photo)

CHICO — Older Americans face losing their driving privileges, and a big chunk of their independence, when diminishing sight, hearing, reflexes and something called cognition (awareness, perception and judgment) conspire to make them unsafe on the road.

Sometimes concerned family members decide the time has come to take away the keys. Less frequently, authorities such as the police or the Department of Motor Vehicles are involved.

A surprising number of seniors heed the warning signs, and take themselves off the road. "It's always better if the person makes the decision to stop driving on their own," said Katie Hoiland, an occupational therapist with Enloe Medical Center.

Hoiland was among a panel of three medical experts at a recent symposium attended by about 65 seniors, all hoping to safely extend their driving years as much as possible. The event took place during National Rehabilitation Week, Sept. 16-22, in recognition of the fact that physical therapy and mental reconditioning can get seniors who have stopped driving for a number of reasons safely back behind the wheel.

So, what are the signs someone's driving skills may need to be evaluated?

According to Dr. Phillip Filbrandt, a rehabilitation specialist, people with a history of falling frequently, impaired vision and cognition, as well as medical issues such as mini strokes, exhibit "predictors" that may translate to perilous driving. Other signs, occurring behind the wheel, are more obvious and include honked at frequently by other drivers and incorrect signaling/leaving blinker on. (See more signs in sidebar this page.)

Many of the warning signs are connected to vision problems. "Research shows that 90 percent of the input needed for safe driving is visual," said Eileen Kennedy, an occupational therapist with Enloe.

The most common vision problems among older Americans include macular degeneration, in which the "central" field of vision is occluded; "patchy" vision which randomly distorts objects in the field of vision, as well as cataracts and glaucoma. Some of these conditions can be treated, others can't.

Glare is another obstacle, and older eyes don't adjust to it as quickly. Kennedy recommends driving with sunglasses on bright days. Lenses in unusual colors often work better at reducing glare than the traditional gray-green tints. "Experiment at the store with various lenses and see what works best for you," Kennedy advised.

Low vision at night is another limitation, and for unknown reasons, Kennedy said the problem is more common among women.

Filbrandt, just 55, said he's already experiencing challenges that have forced him to reevaluate his driving habits, and includes himself in an age group that should be thinking about their abilities behind the wheel.

Filbrandt said patients should refrain from driving right after taking any new medications, just to see how they will react.

Older drivers are one of the safest groups, but the most likely to be injured in a crash, noted Filbrandt, who said air bags deploying at 130 mph can leave serious physical trauma. As a practical tip, Hoiland said she advises drivers to tilt their steering wheel so the car emblem is facing their upper torso, not their face.

Equipment standard in most vehicles, like seat belts, mirrors and adjustable seats, can also be positioned to make motoring safer and more comfortable. Kennedy said backup cameras in some newer cars, and available as an after-market addition, mitigates a dangerous problem — the inability for drivers to turn their heads to see behind them.

Studies show that one in four drivers in America is 65 or older, and that number is growing. As an example of how that statistic can impact society, Kennedy related an amusing story about traffic accidents going way up in Florida towns between 4 and 6 p.m., because so many senior citizens were heading out to early bird specials.

Family members have a number of ways they can lower the boom on a loved one whose driving days must end, and few of them are good. Experts advise approaching the topic gradually over time, when problems first arise. Sometimes friends or trusted advisors, such as a clergyman or doctor, are the best people to deliver the bad news, Hoiland said.

Enloe offers comprehensive testing to determine if seniors or people with medical problems still posses the skills and physical ability to safely drive. Hoiland said it evaluates such areas as mobility, strength, balance, reach, vision and hearing, as well as checking for signs of clinical dementia. Enloe charges $100 for the screening if it's paid on the same day, and $200 if the client asks to be billed. An order from a physician requesting the evaluation is required.

Filbrandt recommends older drivers be tested every five years.

By limiting the miles they drive, the times of day, and by planning their routes, Hoiland said seniors can minimize their exposure to situations that may tax their driving skills.

Chico resident Stephen Burgess, 72, was unable to drive after suffering a stroke. He said extensive rehabilitation through Enloe, and a little understanding from the DMV, helped him regain his driving privileges.

"You can't believe how carefully I drive now," said Burgess. Right after his stroke, Burgess said he had almost no confidence he would ever get his license back.

Giving up that cherished role behind the wheel is a fact of life for just about everyone eventually, but addressing medical issues, and taking a realistic approach to driving abilities, can often extend time on the road by years.

Life after driving can have a big upside, according to Hoiland, who said many seniors experience improved social connections as they depend more on family and friends to get them around, or learn to use public transportation.

A driving evaluation appointment can be made by calling Enloe at 332-3254.

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Trouble on the road? Watch for the signs

According to Dr. Phillip Filbrandt, a rehabilitation specialist, people with a history of falling frequently, impaired vision and cognition, as well as medical issues such as mini strokes, exhibit "predictors" that may translate to perilous driving.